在老年和息护理中以患者为中心的目标一致性:一个范围审查
Isaac S Chua1,2,3, Annelise Berler4, Kacy Ninteau5
1Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
JAMA network open
|September 4, 2025
概括
这项研究确定并描述了严重疾病患者和老年人的目标一致性. 它提出了一个概念模型来指导老年和息护理的未来测量发展.
科学领域:
- 老年医学
- 缓和护理
- 医疗服务研究
背景情况:
- 目标一致对于严重疾病和多病症和老年综合征的老年人高质量护理至关重要.
- 目前还没有衡量目标一致性的标准化方法.
- 现有措施需要进行评估,以确保它们准确地反映患者和护理人员的观点.
研究的目的:
- 确定和描述患者和护理人员报告的目标一致性指标.
- 开发一个概念模型来测量严重疾病和老年人群的目标一致性.
- 在老年医疗和息护理领域开发强大的测量工具.
主要方法:
- 通过电子数据库 (MEDLINE,Embase,Web of Science,CINAHL,PsycINFO) 进行了全面的范围审查,截至2024年9月.
- 包括的研究包括各种设计 (RCT,观察性,定性等) 专注于目标一致性措施.
- 两个独立的审查者进行了数据提取和综合,以确定测量特征和框架模式.
主要成果:
- 63项研究符合纳入标准,产生67项独特的目标一致性指标.
- 大多数研究集中在患有严重疾病的患者身上.
- 开发了一个概念模型,包括四个关键组成部分:患者偏好,接受/预期的治疗,与偏好保持一致以及结果的实现.
结论:
- 本综述提供了针对脆弱患者群体的现有目标一致性措施的全面概述.
- 提出的概念模型为开发和完善未来的测量工具提供了一个框架.
- 这些发现对于在老年医学和息治疗中推进以人为本的护理具有重要意义.
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